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HomeMy WebLinkAbout02-0554PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Eslate of Sara A. Miller also known as n/a Deceased. Socia! Security No. 1 g9_(15_H~gt To: ~~~~ Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl ies for letters of administration (d.b.n.; pendente lire; durante absentia; durance miuoritate) the above decedent. on the estate of Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 17 Rockledge Dr Mechanicsburg PA _ (hst street, number and municipality) Decendent, then 82 years of age, died Tanuarv 74 at C ,~-2D02_, Decendent at death owned property with estimated values as folllows: Qf domiciled in PaJ All personal property $ 4O 7011 n0 _ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in PaJ Personal property in County g - Value of real estate in Pennsylvania $ situated as follows: .._ - Petitioner- after a proper search ham ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: ,.,..~_ T c~ x"G 9 ~ C'u A'u .~.4 ~ O 124 W. Portland St., Mechanicsburg, PA A_ m N THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in Che appropriate form to the undersigned. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA t s~_,. COUNTY OF Cumberland J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal , , representative(s) of the above decedent petitioner(s) will well and _. t l administer the estate according to law. ru y - Sworn to or affirmed and subscribed before me this ~ i *r, day of June yr) ,~° >.~ c~G Y C LE[d~5 Reglster~ l No. 7 ~ -n Estate Of Sara A. Miller ,Deceased GRANT OF LETTERS OF ADMINISTRATION :'. m m rn AND NOW June 11 1x2002, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that Edmund G. Miller is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to Edmund G. Miller in the estate of FEES 00 g0 Letters of Administration . • ~ • • $ . g 00 Short Certificates( ) .......... $ , Renunciation ................ $ ~cp $ 5.00 TOTAL _ $ 84.00 Filed 6-11-02... ... A.D. ``f~ Y C LEWI egister of Willa James W Abraham Esa• #46352 _ ATTORNEY (Sup. Ct. I.D. No.) 513 N 2nd St Harrisbtara, PA 17101 ADDRESS 717-232-7825 PHONE called atty 6-11-02 MARNING: IT IS II_I_EGAL TC ALTER T!-!!S CCPY CR TO DUPLICATE EI'V PHC~1'OSl'AT OR PhOTOGRAPH. <, i>r-ci .~ 1 ~° -i-~-. ;~.; 5037445 'I~ ` ~~ ~~.~-a,,.z ~. ~~ sec ~ ~ ~,~~ /~9-~s--/r~Y/ _ t; ~ ~., / ~Y-o2 ~t C/.~,.~a,~,ciu,~r~.~,~!v~6p~;.~.~,~ C~~~,~:~/.~~ ~~~~-n Tom. ,,~~;F~ i ~ ~-~enr'~ // ~ ,: ,.. ~f~crl'i~~ n ulin;AUdreSS /71C '~-.1~ic..~7-r~~`~9-!~C<J"~u~ ~~71)..%t,f~ ~ c~/ 1 ,;~r, . >, ~' f~F ~ ~ ~ f ~~~~ ,~ ,~ ,, •-u ~~ ~.3a1" ~ ~.~ C,~J_~ C d!°_~ I, __ __ _ ~~ r, ,,,< - -- - _ . ~ ~"r ~-~11; Describe how injury c~ i -_ x, ,. ., I ~ _ ~rD ~ I - _ _ _ ;tigaior ~~=r~, Lr>,in ,I .Determined _~ - _ _ `id ~-~ r>. 7tir, .c .~ /~.3r G~~~~ lj-a~~~• ~-,doff ~• / 7d- ` `~" ~i I ~-F ~ ~~ umatlon here given is correr.tly r.ul; t~: 'r ,-. .., tf~ me °.s Loral Re istrar The ~ngi 9 nal cc r ~ c~~1e ~i ` rr .', t.. : ~~~~ (~ :^ce icr ~ermenent filing. O ROISTER OF WILLS rrMgERLAND nr y pgNN yLVANIA INVENTORY Estate of Sara A. Mill r also known as Deceased. No. 2002-00554 Date of Death 1 24 2 Social Sec. No. 199-05-6241 Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the folowing inventory includes all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: James W Abraham Esc I.D. No. 46352 Address: 513 North nn ~rrisburq, PA 17101 Telephone: 717-232-7g2~ Descri8 ion Personal Representative: Edmund Mill r Dated: 10/24/02 1. PNC Bank Premium Plan Account 2. PNC Bank Certificates of Deposit 3. First Union Bank Certificates of Deposit 4. Personal property - clothing, personal effects Total: value $15,479.81 17,753.50 18,583.79 200.00 X52.017 10 COMMONWEALTH OF PENNBV LVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HAgR188URG, PA 1 ~ 1280601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 001768 ABRAHAM JAMES W ESQ 513 NORTH SECOND ST HARRISBURG, PA 17101 rala ESTATE INFORMATION: ssN: tss-o5-sz4t FILE NUMBER: 2102-0554 DECEDENT NAME: MILLER SARA A DATE OF PAYMENT: 10/24/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/24/2002 REMARKS: CHECK#380 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 51,976.76 REV-1162 EX111-961 TOTAL AMOUNT PAID: INITIALS: JA RECEIVED BY: REGISTER OF WILLS 51,976.76 MARY C. LEWIS REGISTER OF WILLS ~~~ PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: Will No.: Admin. No.: 2002-00554 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 2. 3. A B C D Date: 10/24/02 Did the personal representative file a final account with the court? Yes No x The separate Orphans' Court No. (if any) for the personal representative's account is: Did the persona] representative state an account informally to the parties in interest? Yes aoc No Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. See attached Family Settlement Agreement f ~ ,C''/ Signature James W. Abraham, Esq. Name (Please type or print) Abraham Law Offices 513 North Second St Harrisburg, PA 17101 Address (MAH:rmUAM3) Sara January 24,2002 No If the answer is No, state when the personal representative reasonably believes that the administration will be complete: If the answer to No. 1 is yes, state the following: 717.232:7825 Telephone No. Capacity: Personal Representative roc Counsel for Personal Representative R.W.-27 FAMILY SETTLEMENT AGRBSMENT AND FINAL RELEASE IN THE ESTATE OF SARA A_ MILT ER KNOW ALL MEN BY THESE PRESENTS, that whereas, SARA A. MILLER, late of 17 Rockledge Drive, Mechanicsburg, Pennsylvania, 17055, died intestate on January 24, 2002. WHEREAS: Letters of Administration of the Estate of said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania on June 11, 2002, to Edmnud G. Miller, son the decedent, as Administrator of said Estate, hereinafter referred to as Personal Representative; WHEREAS: The said Personal Representative has gathered the assets of the Estate of the said decedent and the assets consist of personal property. The Statement of Account of the said Personal Representative, which is attached hereto and made part hereof as Exhibit "A", constitutes the assets gathered, the debts paid, the disbursements made, and the distribution to all respective parties hereto; WHEREAS: the balance/remainder of the Estate property has been distributed by the Personal Representative in accordance G~ith this Family Settlement Agreement and as stated in the Statement of Account (Exhibit ~~A~~). NOW THEREFORE, KNOW yg, that 2, Edmund G. Miller, son of the decedent, the person entitled to inherit under the Estate and as Personal Representative of the Estate hereto, do hereby acknowledge that I have received and/or accepted, this day, the disbursement as sole beneficiary of the Estate, in full satisfaction and payment of all sum or sums of money, legacies, bequests, and devises as are given and/or inherited pursuant to the Estate, which amounts I have received and/or accepted this day; and which amounts are in the amounts set opposite my name in the Distribution Schedule in the Statement of Account, attached hereto and made part hereof as Exhibit "A~~. AND, I hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, I agree that no account is necessary and I hereby agree to distribution being made without the filing of an account, with this Agreement to have the same force and effect as if an account had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas, Cumberland County, Pennsylvania. I, EDMUND G. MILLER, hereby covenant and agree that should any liability come due to the Estate of the said decedent after the signing of this Agreement, I hereby covenant and agree that I, as sole beneficiary of the Estate, shall be responsible to satisfy any and all claims, demands, suits or causes of action which may be successfully prosecuted against the said Estate or myself as Personal Representative of the Estate hereto, after the signing, sealing and delivery of this Family Settlement Agreement and Final Release. 2 IN WITNESS WFiSRgpF,/~~we have-hereunto set our hands and seals this ~~F~ day of l/Crt)~ 2002. WITNESS: ~d~,t, Cam. ~~.~.._. EDMUND G_ MILLER 3 DATE OF DEATH: LETTERS GRANTED I. ASSETS: EXHIBIT "A" STATEMENT OF ACCOUNT BSTATE OF SARA A. MILLER January 24, 2002 June 11, 2002 1. PNC Bank - Premium Plan Account No. 50-0350-3271 2. PNC Bank - Certificates of Deposit 3. First Union Bank - Certificates of Deposit 4. Personal Property - Clothing and personal effects. TOTAL ASSETS: II. DEBTS/DISBURSEMENTS; Item 1. Funeral Expenses - Ronald C.L. Smith Funeral Home 2. Register of Wills - Cumberland County Fiing Fee. 3. PA Department of Revenue - Inheritance Tax 4. Legal Advertising - Harrisburg Patriot News Cumberland Law Journal 5. Attorney Fees - Abraham Law Offices TOTAL DEBTS/DISBURSEMENTS: III. SUMMARY: ASSETS/DEBTS/DISBURSEMENTS: A. Total Assets: B. Total Debts/Disbursements: TOTAL NET ASSETS FOR DISTRIBUTION: IV. DISTRIBUTION: A. Edmnud G. Miller - Son of Decedent 4 Value/Amoun 15,479.81 17,753.50 18,583.79 200.00 $52,017.10 Amo n $4,743.00 94.00 1,976.76 177.10 75.00 3.000 00 $10,065.86 $56,017.10 10.06s 86 $45,951.24 $45,951.24 Rev'5<XE.X'11~7J* ,- COMMONWEALTH F PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENTS N.AME (LAST. FIRST. AND MIDDLE INfTlAl) use a blank block ID 5el).1'81e words w ~ ~-'" u~~ W~U ,00 u~~ ~. ~ < z o >= X;:! ;:!:> 0- ::;; o u REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT U;tG'~i.Y 'F",J~-_J.,-:c,+~,+!o~9L....~,,+....k2,,+,.,.~...,.~, ..~II.I:NU'1lEIl , . . . Q, oJ).. 551/ CCOE '\'FAA HUMBER .... Z W C W o W C Miller S a r a A, SOCIAL SECURITY NUMBER DATE OF DEATH DATE OF BIRTH 01124/20 o 2 04119/1919 199-05-6241 {IF APPLICABLE] SURVIVlNG SPOUSE'S N.AME (LAST, FIRST. AND MIDDLE INITIAl) SOCIAl SECURITY NUMBER THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS ~ z w o z o ~ '" w ~ ~ o u ~1 Original Return 0 2. Supplemental Return 0 3. Remainder Return {date ofOeath prior 10 12-13-82] D 4. Limited Estate D 4a. Future InterestComprom.. ('''''''''''''''''''''''1 D 5. Federal Estate Tax Return Required D 6. Decedent Died Testate (Attach copy of Will) 0 7, Decedent Maintained a Living Trust {Attach copy of Trust) _ 8. Total Number of Safe Deposit Boxes D 9. Litigation Proceeds Received D 10. Spousal Poverty Crad.(""',,_....." ".31.91 "" ,.,.", D 11. Election to tax under Sec. 9113(A) _'&'01 THIS SECTION MUST BE COMPLETED. ALL CORRESPONDee\ANPi , peNT '.l;'I'AXINFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS James W. Abraham, Esq. James W. Abraham, Esq. FIRM NAME (If Applicable) Abraham Law Offices . Abraham Law Offices 513 North Second St. TELEPHONE NUMBER Harrisburg', PA: 11101... '717 232 7825 . . 1. Reai Estate (Schedule A) (1) 2. Stocks and Bonds (Schedu~ B) (2) 3. Closely Held Corporation,Partnership or Sole--Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) Z (Schedule E) 0 6. Jointly OWned Property (Schedule F) (6) ~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property ..J (Schedule G or L) (7) ~ .... 8. Total Gross Assets (total Lines 1-7) c: <( g. Funeral Expenses & Administrative Costs (Schedule H) (9) 0 W a:: 10 Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) ,0-- -0- , f' ,0- -0- 1 5 6 7 9 8 1 3 6 , 3 3 7 2 9 -0- , 5 2 017 1 0 (6) 808910 , -0- , (11) 8 o 8 9 1 0 , 4 3 928 o 0 -0- 4 3 ,9 2 8 o 0 -0- 1 ,9 7 6 7,6 -0- 1 ,9 7 6 7 6 12. Net Value of Estate (line 6 minus Line 11) (12) 13, Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subjectto Tax (Une 12 minus Line 13) (14) 15. Amount of line 14 taxable at the spousal tax rate , See instructions on reverse side for applicable percentage 16. Amount of line 14.taxabie 4 3 9 a~rate 4.:>',70 , 17. Amount of line 14 taxable a115% rate X.O (15) 2 8 o 0 x ~4.5~) x .15 (17) 18. Tax Due (18) 19. Portland St. iMechanicsburg, PA DATE 17055 (0-;23-0:l.. DATE ADDRESS 513 N. 2nd Harrisburg, PA 17101 "'~ c., I (] -;:rJ' {):J-. Decedent's Complete Address: STREET ADDRESS 17 Rock1edge Drive CITY Mechanicsburg T STATE I ZIP p~ 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 18) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 1,976.76 3. InteresVPenalty if applicable D. Interest E. Penalty Total Credits (A + B + C) (2) -0- T otallnteresVPenalty ( D + E ) (3) -0- 4. If line 2 is greater than line 1 + line 3, enter the difference. This Is the OVERPAYMENT. Check box on Plge1 Line 19 to requeet I refund (4) 5. If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5) 1, 976. 76 A. Enter the interest on the tax due. (5A) -0- S. Enter the totai of Line 5 + 5A. This is the BALANCE DUE. (5B) 1 i 976.76 Make Check Pay"able to: REGISTER OF WILLS, AGENT II II _ m r PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ............................................................. 0 ~ b. retain the right to designate who shall use the property transferred or its income; ................ 0 KJ c. retain a reversionary interest; or............................................................................................. 0 ~ d. receive the promise for life of either payments, benefits or care? .........................................0 kJ 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................. 0 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ...............................................................................................................".....0 KJ 4. Did decedent own an individual retirement account, annuity, or other non-probate property?.... 0 KJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN 72 P.S. ~9116 (a) (1.1) (i) provided for the reduction of the tax rate imposed on the net value of transfers to or for the use of the surviving spouse from 6% to 3% for dates of death on or after July 1, 1994 and before January " 1995. 72 P.S. ~9116 (a) (1.1) (Ii) provided for the reduction of the rate imposed on the net vaiue of transfers to or for the use of the surviving spouse from 3% to 0% for dates of death on or after January " 1995. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the oniy beneficiary. FOR DATES OF DEATH ON OR AFTER JANUARY 1,1995. Please answer the following question by piacing an "x' in the appropriate space. Did the decedent create a trust or similar arrangement which is solely for the surviving spouse's benefit for his or her entire lifetime? Yes 0 No 6a If you answered yes to the above question, the tax on the trust or similar arrangement is postponed until the death of the second spouse, at which time it will be fully taxable at the rate(s) applicable to the remainder beneficiary(ies). Enter the value of the trust on Schedule J, Part II, in order to remove i!from the calculation of the tax due in this estate. You may wish to file Schedule 0 in order to make the election available under Section 9113. If the election is made, the trust or similar arrangement is taxed in the estate of the first decedent spouse, the portion of the trust or similar arrangement which benefits the surviving spouse is taxed at the zero tax rate, and the remainder is taxed at the rate(s) applicabie to the remainder beneficiary(ies). if you choose to make the election, you must attach Schedule 0 to a timely-filed tax return, along with Schedule(s) K andlor M in order to show the apportionment of the trust or similar arrangement between the surviving spouse and the remainder beneficiary(ies). F1EV.l506 EX + (1.97) *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ;-' ,"... COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Miller, Sara A. FILE NUMBER 2002-00554 ESTATE OF Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned wtth the right of survivorship must be disclosed on SChedule F. ITEM NUMBER 1 DESCRIPTION PNC Bank - Premium Plan Account No. 50-0350-3271 VALUE AT DATE OF DEATH 15,479.,tl1 2. Personal Property - Clothing and personal effects. 200.00 15,679.81 TOTAL (Also enter on line 5, Recapijulation) $ (If more space is needed, insert additional sheets of the same size) REV-'509EY'11-97)~ --~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF Miller, Sara A. FILE NUMBER 2002-00554 If an asset was made joint within one year of the decedent', date of death, It must be reported on Schedule G. SURVIVING JOINT TENANT(S} NAME ADDRESS RELATIONSHIP TO DECEOENT A Edmund G.-Miller 124 West Portland St., Mechanicsburg, PA 1705 -" Son B c JOINTLY -OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF 1 DF<.TEOFDEATH ITEM FOR JOINT MADE Include name of financial institution arxl bank account number or similar Identifying number, Attach DATE OF DEATH DECO'S VALUE OF NUMBER TENANT JOINT deed lorjoirllly-held real estate. VALUE OF ASSET IN1EREST DECEDENT'S INTEREST 1 A 1997 PNC Bank Certificates of Deposit 35,507.00 50% 17,753.50 2. A 1997 First Union Bank Certificates of Deposit 37,167.58 50% 18,583.79 TOTAL (Also enteron line 6, Recapitulation) $ 36,337.29 (If more space is needed, insert additional sheets of the same size) ""',...".. -". -^.." ,. . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENt OECE ENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS Miller, Sara A-.. FILE NUMBER 2002-00554 ESTATE OF Oebts of decedent must be reported on Schedule I, ITEM NUMBE~ DESCRIPTION AMOUN' A FUNERAL EXPENSES 1. Ronald C.L. Smith Funeral Home 4,743.00 325 North High St., Duncannon, PA 17022 . a ADMINISTRA TIVE COSTS: 1 Personal Representa~ve's Commissions Name of Personal Representative (s) Sodal Security Number(s) I E1N Number of Personal Representative(s) Street Address City Slate Zip Year(s) Commission Paid: 2 Attorney Fees Abraham Law Offices 3,000.00 3 Family Exemption: (If decedenl's address IS not the same as claimant's. attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Deceden\ 4 Probate Fees Register of wills, Cumberland County, PA 94.00 5 Accountant's Fees 6. Tax Return Preparers Fees 7 Legal Advertising. Patriot News, Harrisburg, PA 177.10 Cumberland Law Journal, Carlisle, PA 75.00 TOTAL (Also enter on line 9, Recapitulation) 8,089.10 $ Ilf more space is needed, insert additional sheets of the same size) .. SCHEDULE J BENEFICIARIES :JMMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 2002-00554 Miller, Sara A. NUMBER NAME AND ADDREBS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Edmund G. Miller 124 W. Portland Drive Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE Son llDO"h ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET J J NON-TAXABLE DISTRIBUTIONS: A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARIT ABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional.sheets of the same size) ~~~ 69-~ J BUREAU DF INDIVIDUAL TAxES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, pA 171za-oval NOTICE OF INHERITANCE TAX APPRAISEMENT ALLONANCE OR DISALLONANCE OF DEDUCI'ZON~, AND ASSESSMENT OF TAX ON JOINTLY NELD OR TRUST ASSETS aev as<e ex ,rv avt-om '03 JUN ZO f!1 i EDMUND G MILLER JR 17 ROCKLEDGE DR MECHANICSBURG PA 170554- ~-~- DATE 06-23-2003 ESTATE OF MILLER SARA A DATE OF DEATH 01-24-2002 FILE NUMBER 21 02-0554 ~UNTY CUMBERLAND ~$SN/DC 199-05-6241 ACN 02133111 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ----- RETAIN LOWER PORTION FOR YOUR RECORDS 1 REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 06-23-2003 ESTATE OF MILLER SARA A DATE OF DEATH 01-24-2002 COUNTY CUMBERLAND FILE N0. 21 02-0554 S.S/D.C. N0. 199-05-6241 ACN 02133111 TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: pNC BANK ACCOUNT N0. 31100186045 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 05-04-2000 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 5,462.57 X 0.500 2,731.29 - .00 2,731.29 X .15 409.69 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID INTEREST IS CHARGED THROUGH 07 -01-2003 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 409.69 REVERSE SIDE DF THIS FORM INTEREST AND PEN. 14.78 TOTAL DUE 424.47 ~ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. , ( IF TOTAL DUE IS LESS THAN 81, NO PAYMENT IS REpUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ( CR), YOU MAV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. 7 PURPOSE OF NOTICE: To fulfill the requiremenks of Section 2140 of the Inheritance and Estate Tax Act. Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice antl submit with Yaur Davment to the Register of Wills printetl on the reverse sitle. -- Make check or money order payable ko: REGISTER OF WILLSr AGENT. REFUND (CR): A refund of a taz cretlit, which was not requested on The tax re ku rn, may be requested by completing an "ADplicatign for Refund pf Pennsylvania Inheritance and Estate Tax" (REV-1313). ApPlicakipns are available at the Office pf the Register of Wills, env of the 23 Revenue District Df Fices or by calling the special 24-hour an sure rind service for forms ordering: 1-800-362-2050; services for taxpav ors wi kh special hearing and or speaking needs: 1-800-447-3020 (TT on1Y)• OBJECTIONS: Anv party in inkeresk not satisti ed with the appraisemenkr allowance, or disallowance of detluckions or assessmOnk of Tax (including tli scount or interesU as shown on this Notice nay obieck within sixty (60) tlavs of receipt of this Notice bv: --w rikten Orotes4 ko the PA Department of Revenue, Board of Appeals. Dept. 281021. Narrisbu rpr PA 17128-1021. OR --electing to have 4he matter determined at the autlit of the account of the personal representative, OR --appeal to the Orphans' Court ADMIN- ISTRATIVE CORRECTIONS: Factual errors tli stave retl on this assessment shoultl be atld ressed in writing to: PA Oepa rtnent of Revenue, Bureau of Intlivitlual Taxes. ATTN: Post Assessment Review Unit, DEPT. 280601, Na rrisbu rp, PA 17128-0601 Phone (717) 787-6505. Sae gape 5 of the booklet "Instructions for Inhe rikance Tax Return for a Resident Decedenk" CREY-1501) for an explanation of atlaini st natively correctable errors. OISCDUNT: If env tax due is Paitl within three (3) calendar months after The decedent's deakh, a five percent (5Y.) tliscounk of the tax paid is allow etl. PENALTY: Tha 15Y. tax amnesty non-Participation pen ally is computed on the tokal of the tax antl inkeresk assessetl, and nok Paid before Janua rv 1H. 1996, the first day after the end of the fax am pesky Periotl. This non-participation venally is appealable in The same manner and in the the same 4ime Period as You would aPPeal The tax antl interest that has been assessed as indicated on this notice. INTEREST: Inkerest is charged beginning with first tlav of delinquency, ar nine (9) months antl one (1) day f non the tlate of tleath. to the date of pavmenk. Taxes which became delinquenk before Janua rY 1, 1982 bear interest ak the rate of six (b%) Percent per annum celculatetl ak a daily rate of .000164. All taxes which became delinquenk on or after Janua rY 1. 1982 will bear interest at a rake which will vary from calendar Year ka calendar Year with That rate announced by the PA Deparknenk of Revenue. The applicable interest rakes for 1982 through 2003 are: Interest Daily Inkerest Dai1Y Intere sf Daily Year Rate Factor V~ar Rafe Factor V~ar Rate Factor 1982 20X .000548 1987 9X .000247 1999 7X .000192 1983 16X .000438 1988-1991 11Y. .000301 2000 8X .000219 .000247 1984 11Y. .000301 1992 9Y. .000247 2001 9X 1985 13Y. .000356 1993-1994 lY. .000192 2002 6Y. .000164 1986 10X .000274 1995-1998 9X .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINpUENT X DAILY INTEREST FACTOR --Any Notice issuetl after the Tax becon es delinquent will reflect an inYa rest calculation to fifteen (15) days bey ontl the date of She assessment. If payment is made after the interest cam puYation data shown on The Notice, additional interest must be calculated. ~~-~~- ~ BUREAU OF INDIVIDUAL TAXES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAx O1v1s1oN DEPARTMENT OF REVENUE DEPT. 280601 HARR I58HRG, pA 1712a-0681 NOTICE OF INHERITANCE TAX APPRAISEMENi, ALLOWANCE OR DISALLONANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-154) E% AFP fRl-YRl DATE 12-10-2002 ESTATE OF MILLER SARA p DATE OF DEATH 01-24-2002 FILE NUMBER 21 02-0554 JAMES W ABRAHAM ESO COUNTY CUMBERLAND ABRAHAM LAW OFFI CES ACN 101 513 N 2ND ST Anount Remitted HBG PA 17101 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG TMIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT ----------------- A O E , LL WANC OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MILLER SARA A FILE N0. 21 02-0554 ACN 101 DATE 12-10-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ( )CHANGED Ai5ED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expanses (Schedule H) (q) 8,089 .10 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00 11. Total Deductions 12 N t (11) A.OA9 10 . e Value of Tax Return 43 928 00 13. Charitable/Governmental Bequests) Non-elected 9113 Trus ts (Schedule J] a2) ( . , 00 14. Net Value ofi Estate Subject to Tax 13) ( . 43 928 00 NOTE: if an assessment was issued previously, sines re'Fiect fi ures th t 14, 15 andior ly) 16, 17 18 , . and 19 ill g a include the total of ALL , returns assessed to date w ASSESSMENT OF TAX: . 15. Amount of Lina 14 at Spousal rate (15) .00 00 _ 00 16. Anount of Li 14 t X . ne axable at Lineal/Glass A rata (16) 43,928.00 X 045- 1 976 76 17. Amount ofi Line 14 at Sibling rate (17) 00 12 , . 18. Anount of Line 14 taxable at Collateral/Class B rate [18) . 00 X - 15 .00 19. Principal Tax Due . - X .00 TA C EDITS• (19)= 1,976.76 DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 30-24-2002 CD001768 .00 1,976.76 TOTAL TAX CREDIT 1,976.76 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 (1) .00 NOTE: io insure proper [2) .00 credit to your account, f3] .00 submit the upper Dortion (4) .00 of this fore with your [5) 15.679.81 tax payment. [a) 36.337.29 (n .00 (a) 52,017.10 • IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN O1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A '•CREDIT" (GR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.] RESERVATION: Estates of tlecetlen is dying on or before December 12, 1982 -- if env future interest in the estate is transferretl in possession or enjoyment to Class B (collateral] beneficiaries of the decedent after the exp iratian of env estate for life or For years, the Commonwealth hereby expressly reserves the right to appraise and assess trensFer Inheritance Taxes at the lawFUl Class a (collateral) rate on env such future interest. PURPOSE OF NOTICE: To Fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. [72 P. . Section 9140). PAYMENT: Detach the tap pcrticn of this Notice and submit with your paymenk to the Register of Nills printetl on the reverse sitle. --Make check or money order payable to: REGISTER OF WILLS, AGENT REFUND [CR): A refuntl of a tax credit, which was nok requested on the Tax Return, mev be requested by completing an "App lice Lion for Rafuntl of Pennsylvania Inheritance and Estate Tax^ (REV-1313). Applications are available at the Office of the Register of Nill s, any of the 23 Revenue District Offices, or by calling the spacial 24-hour answering service far forms ordering: 1-800-362-2050) services for taxpayers with special has ring and / ar speaking needs: 1-800-447-3020 (TT on lv). OBJECTIONS: Anv Party in interest not satisf iatl with the app raisement, allowance, or tlisa llowance of detluctions, or assessment pf tax (inclutling discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Nc tiee by: --x ritten pro task to the PA Department a4 Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1023, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assasment should be adtlrassed in writing tHa rrisbu rparPA n1712B-0603ue, Bureau of Intlivitlual Taxes, ATTN: Post Assessment Rev ieu Unit, Dept. 28 D601, 9. Phone [717) 787-6505. See page 5 of the booklet ^Instruc ticns for Inheritance Tax Return for a Resident Decedent" (REV-1501] for an explanation of atlministra[ive ly correctable errors. DISCOUNT: If env tax due is paid within three [3) calendar months after the tlacadent•s death, a five percent (5%] discount of the tax paitl is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed an the total of the tax and interest esse ssetl, antl not paitl before Jenua ry 18, 1996, the first tlay after the end of the tax amnesty pe riotl. This non-participation penalty is appealable in the same manner and in the the same time perictl as you woultl appeal the tax and in[eresi that has been esse ssetl as indicated an this notice. INTEREST: Interest is charged beginning with First day of tlelinquency, or nine [9l months and one [1) dev from the date of death, to the date of payment. Taxes xhich became delinquent before January 1, 1982 bear interest at the rate of six (6%] percent per annum calculated at a daily rate of .000164. All taxes which became delinquent an and after January 1, 1982 will bear interest at a rata which will vary from calendar year to ca )antler Year with that rate ennouneetl by the PA Department of Revenue. Tha applicable interest rates For 1982 through 2002 are: Year Interest Rate Oa ilY Into rest Factor 1982 1983 1984 1985 1986 198] 1988-1991 Year Intare st Rate Daily Interest Factor 20% .000548 1992 9% .000247 000192 16% .000438 1993-1994 ]% . 000247 11% .000301 1995-1998 9% 7% . .000192 132 .000356 1999 8% .000219 10% .000274 2000 9% .000247 q2 .000247 2001 6% .000164 11% .000301 2002 --Interest is calcine tetl as Follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYB DELINQUENT X DAILY INTEREST FACTOR --AnY Notice issuetl after the tax becomes delinquent will reflect an interest calculation [o fifteen (15) tlays beyontl the data of the assessment. IF paYnent is wade after the in [eras[ computation data shown on the Notice, atltlitienal iota rest musk be ealculatetl. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EXI11-961 BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1]128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 002775 ABRAHAM JAMES W ESQ 513 NORTH SECOND ST HARRISBURG, PA 17101 ' ACN ASSESSMENT AMOUNT CONTROL _---_ ola NUMBER ESTATE INFORMATION: ssrv: iss-o5-sz4i FILE NUMBER: 2102-0554 DECEDENT NAME: MILLER SARA A DATE OF PAYMENT: 07/08/2003 POSTMARK DATE: 07/07/2003. COUNTY: CUMBERLAND DATE OF DEATH: 01/24/2002 REMARKS: CHECK#474 SEAL 02133111 ~ $424.82 TOTAL AMOUNT PAID: INITIALS: VZ RECEIVED BY: REGISTER OF WILLS $424.82 DONNA M. OTTO DEPUTY REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1 762 IiX~11-96) BUREAU OF INDI VIp UAL TAXE$ DEPT. 280601 HARRISBURG, PA 1 J 1280601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 002776 ABRAHAM JAMES W ESQ 513 NORTH SECOND ST HARRISBURG, PA 17101 ACN ASSESSMENT AMOUNT CONTROL NUMBER ,old ESTATE INFORMATION: ssN: iss-o5-sz4i FILE NUMBER: 2102-0554 DECEDENT NAME: MILLER SARA A DATE OF PAYMENT: 07/08/2003 POSTMARK DATE: 07/07/2003 COUNTY: CUMBERLAND DATE OF DEATH: 01/24/2002 REMARKS: CHECK# 476 SEAL 02122113 ~ 51,300.46 TOTAL AMOUNT PAID: INITIALS: VZ RECEIVED BY REGISTER OF WILLS 51,300.46 DONNA M. OTTO DEPUTY REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE REV-1162 EXI11-961 BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA iJ126-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 002777 MILLER EDMUND G 124 WEST PORTLAND ST MECHANICSBURG, PA 17055 ACN ASSESSMENT AMOUNT CONTROL _-___ loll NUMBER REMARKS: EDMUND G MILLER JR CHECK# 475 SEAL 02133112 ~ 52,335.79 TOTAL AMOUNT PAID: INITIALS: VZ RECEIVED BY: REGISTER OF WILLS 52,335.79 DONNA M. OTTO DEPUTY REGISTER OF WILLS ~i~-69-~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TA% DIVISION DEPT. 288601 HARRISBURG, PA 17128-8601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE APPRAISEMENTB ALLONANCETORCDISALLONANCE OF DEDUCTION, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS wxv-ssae a nm :o~-om EDMUND G MILLER JR Oj JUI'J ZO 17 ROCKLEDGE DR MECHANICSBURG PA 17055 \~.c'~~. Ctm DATE 06-23-2003 ESTATE OF MILLER gggA A DATE OF DEATH 01-24-2002 FILE NUMBER 21 02-0554 C NTY CUMBERLAND ~~~~ /DC 199-05-6241 ACN 02133112 Amount Remittetl MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE -- RETAIN LOWER PORTION FOR YOUR RECORDS 1 REV-1548 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 06-23-2003 ESTATE OF MILLER SARA A DATE OF DEATH 01-24-2002 COUNTY CUMBERLAND FILE N0. 21 02-0554 S.S/D.C. N0. 199-05-6241 ACN 02133112 TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT N0. 21001028651 TYPE OF ACCOUNT: C ) SAVINGS ( ) CHECKING ( ) TRUST Op TIME CERTIFICATE DATE ESTABLISHED 08-20-1993 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 30,034.33 X 0 500 15,017.17 - .00 15,017.17 X 15 2,252.58 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE A80VE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID INTEREST IS CHARGED THROUGH 07 -01-2003 TOTAL TAX CREDIT AT THE RATES APPLICABLE AS OUTLINED ON THE OB REVERSE SIDE OF THIS FORM BALANCE OF TAX DUE 2,252.58 INTEREST AND PEN. 81.29 t IF PAID AFTE C IF TOTAL DUE R THIS DATE, SEE IS REVERSE FOR CALCULATION OF ADDIT IONAL INTERESDUE 2,333.87 IF TOTAL DUE LESS THAN 61, IS REFLECTED AS NO PAYMENT IS REpUIREO. A " " SEE REVERSE SIDE OF THIS FORM CREDIT C CR), YOU MAV FOR INSTRUCTIONS. ) BE DUE A REFUND. \, BUREAU OF INDIVIDUAL raxES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE SAX OFPDEDUCT ON~, AANDN SSESSMENTSOFLTAXNON JOINTLY HELD OR TRUSS ASSETS awns<s a ew ~s~-on r. "~ DATE 06-23-2003 ~''.. ESTATE OF MILLER SARA A DATE OF DEATH 01-24-2002 FILE NUMBER 21 02-0554 03 JUfJ 20 s ~G g L EDMUND G MILLER JR ~'Nr 199 05 6241 17 ROCKLEDGE DR ACN 02133113 MECHANICSBURG pA 17055 =~.t L. Amount Remitted (af1Td;. _; La MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE -- RETAIN LOWER PORTION FOR YOUR RECORDS 1 REV-1548 EX AFP CO1-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS. AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 06-23-2003 ESTATE OF MILLER SARA A DATE OF DEATH 01-24-2002 COUNTY CUMBERLAND FILE NO. 21 02-0554 S.S/D.C. NO. 199-05-6241 ACN 02133113 TAX RETURN WAS: CX) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: pNC BANK ACCOUNT N0. 5140145298 TYPE OF ACCOUNT: ( ) SAVINGS (X1 CHECKING ( ) TRUST C ) TIME CERTIFICATE DATE ESTABLISHED 09-01-1974 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: 16,721.62 NOTE: X 0.500 8,360.81 - .00 8,360.81 X .15 1,254.12 TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ABOVE ADDRESS. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID INTEREST IS CHARGED THROUGH 07 -01-2003 TOTAL TAX CREDIT AT THE RATES APPLICABLE AS OUTLINED ON THE 1 BALANCE OF TAX DUE 1 254 2 REVERSE SIDE OF THIS FORM , . INTEREST AND PEN. 45.26 • IF PAID AFTE R THIS DATE. SEE REVERSE FOR CALCULATION OF DUE N 1,299.38 C IF TOTAL DUE IS LESS THAN fl, NO PAYMENT IS REpUIRED ADDIT IONAL I TERES IF TOTAL OUE SEE REVERSE IS REFLECTED AS SIDE OF TH . A "CREDIT" C CR), VOU MAY BE DUE A REFUND. IS FORM FOR INSTRUCTIONS. ) ~i~69-6 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 288681 HARRISBHRG, Pp 17128-8681 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT ~. EDMUND G MILLER JR 17 ROCKLEDGE DR MECHANICSBURG PA 1705 EEV-lia EM ,FV COI-09 DATE 07-21-2003 ESTATE OF MILLER SARA A DATE OF DEATH 01-24-2002 .-,--FILE NUMBER 21 02-0554 '`COUNTY CUMBERLAND ACN 02133111 Anount Ranittad MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER DF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. ALONG THIS LINE------- RETAIN LOWER PORTION FOR YOUR RECORDS ~ •1607 FY-eeo-ini=na. "'--------------- *** ESTATE OF MILLER SARA A FILE N0. 21 02-0554 ACN 02133111 DATE 07-21-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-23-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 409.69 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 07-07-2003 CD002775 15.12- 4P4,82 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. ~ IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. 1 409.70 .O1CR .00 .O1CR BUREAU OF INDIVIDUAL TAXES INHERITANCE TA% DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 EDMUND G MILLER JR 17 ROCKLEDGE DR COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT PEY-16 A] E% IFO 101-OA UJ i.J IJ= 2rl ~ ~,_~. MECHANICSBURG PA 18.055 ~.; ,. DATE 07-21-2003 ESTATE OF MILLER SARA p DATE OF DEATH 01-24-2002 FILE NUMBER 21 02-0554 COUNTY CUMBERLAND ACN 02133112 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the uDPar portion of this torn with your tax payment. CUT ALONG THIS LINE _-_ RETAIN LOWER PORTION FOR YOUR RECORDS -~ REV-1607 EX AFP (01-03) ^**_INNER7TAIJ-CC ~Tev -cTwr u~S~ ~~ ESTATE OF MILLER SARA A FILE NO. 21 02-0554 ACN 02133112 DATE 07-21-2003 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIDURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-23-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 2,252.58 DATE ^E-a.car 1 NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 07-07-2003 CD002777 83.14- 2,335.79 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. • IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ^CREDIT^ (CRI, YDU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J 2,252.65 .07CR .00 .07CR BUREAU DF INDIVIDUAL TAXES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX DIVISION DEPARTMENT OF REVENUE DEPT. 280601 NARRISBURG, PA vlza-Deol INHERITANC E TAX STATEMENT OF ACCOUNT MEY-160) FC 1F1 <O1-OBI CUT '03 , ul 2~ MECHANICSBURG PA 17055. 1'. EDMUND G MILLER JR 17 ROCKLEDGE DR DATE 07-21-2003 ESTATE OF MILLER SARA A DATE OF DEATH 01-24-2002 FILE NUMBER 21 02-0554 ,`- --'COUNTY CUMBERLAND ACN 02133113 Anount Raeittad MAKE CHECK PAYADLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper crsdi{ to your accoun{, submit {ha upper por{ion of {his Porn Nith your fax eavaen+. THIS LINE - RETAIN X AFP (01-03) **~[ INHE ate)[ ESTATE OF MILLER SARA A FILE N0. 21 OZ-0554 ACN 02133113 DATE 07-21-2003 TNIS STATEMENT IS PROVIDED 70 ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-23-2003 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 1,254.12 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 07-07-2003 CD002776 46.29- 1,300.46 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. • IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS iNAN 51, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ••CREDIi•• (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ] PORTION FOR YOUR RECORDS ~ 1,254.17 .05CR .00 .05CR